Nurs 343 Exam 3 || Exam Mastery Pack: Real
Questions + A+ Verified Answers!!
Anger correct answers is the emotional response to frustration threats, or challenges and is a
normal response. We should not feel guilty about becoming angry but how we respond to that
anger may be a problem, venting anger may not be good in some cases.
Aggression correct answers is a harsh physical or verbal action that reflects rage hostility, and
potential for physical or verbal destructiveness.
Anger and hostility are also risk factors for: correct answers hypertension and cardiovascular
disease. Hostility has been shown to increase adrenocorticotropin and cardiovascular
responses to stress and to increase illness.
Behaviorists Theory- correct answers believe anger was a learned response to environmental
stimuli.
Social learning theorists correct answers such as Bandura, showed children learn by imitating
others and that people repeat behavior that is rewarded. Also children who grow up in angry
families learn to respond to frustration with anger and violence.
Cognitive based theory- correct answers although threat is usually understood as an alert to
physical danger, Beck noted that *perceived* assault on areas of personal domain, such as,
values, moral code, and protective rules can also lead to anger.
Causes of anger and aggression correct answers Brain abnormalities
Serotonin levels
Genetic and environmental factors
Brain abnormalities (Anger) correct answers - such as brain tumors, Alzheimer's temporal
lobe epilepsy, and traumatic injury to certain parts of the brain result in changes to
personality that includes increased violence.
One site known to be associated with aggression correct answers is the limbic system which
mediates primitive emotion and behaviors that are necessary for survival. The amygdala
mediates anger experiences. The temporal lobe is associated with high violence.
Serotonin levels- (Anger) correct answers studies have shown a relationship between
impulsive aggression and low levels of serotonin.
s/s risk of escalating anger leading to aggressive behavior. correct answers •Hyperactivity:
most important predictor of imminent violence (e.g., pacing, restlessness)
•Increasing anxiety and tension: clenched jaw or fist, rigid posture, fixed or tense facial
expression, mumbling to self (patient may have shortness of breath, sweating, and rapid
pulse)
•Verbal abuse: profanity, argumentativeness
•Loud voice, change of pitch; or very soft voice, forcing others to strain to hear
•Intense eye contact or avoidance of eye contact
,What is the single best predictor of future violence? correct answers history of violence
Milieu characteristics conducive to violence: correct answers Determine if environment is
conducive to anger management
Does the staff have the skills needed to handle angry aggressive clients
Are staff numbers adequate
Pre-assaultive stage: correct answers frequently verbal interventions are sufficient during this
stage.
Interventions in pre-assaultive stage: correct answers Analyze the client and situation
Use verbal techniques
Demonstrate respect for the client's personal space
Interact with the client
Invest time in the process
Pay attention to the environment
Assure your safety from violence by: correct answers Avoid wearing dangling jewelry
Have enough staff for backup
Always know the layout of the area
Do not stand directly in front of client or in front of doorway
If escalating provide feedback "you seem upset."
Avoid confrontation with the client either through verbal means or a show of force.
Assaultive stage: correct answers use of restraints, seclusion and medications. Throughout
this time, the team leader continues to relate to the client in a calm, steady voice,
communicating decisiveness, consistency, and control.
Postassaultive stage- correct answers once seclusion is no longer needed the staff should
review the incident with the client and with staff members. It can be a learning moment for
all concerned. For the client their out of control behavior.
Clients with cognitive deficits correct answers are particularly at risk for acting aggressively.
Can be from Alzheimer's or other dementia or brain injury.
Catastrophic reaction correct answers Sometimes the client with a cognitive disorders
experiences such severe agitation and aggression that it is referred to as a catastrophic
reaction.adopts a calm and unhurried manner.
Validation therapy for cognitive deficits correct answers lets you begin emotionally where the
client is
It grounds the client where he or she feels most secure
It is often more helpful to reflect back to the client the feelings behind her demand and to
show understanding and concern for her worry. As the nurse establishes himself or herself as
a safe understanding person, the client becomes calmer and more open to redirection.
Anger can be defined as
A. an unhealthy way of releasing anxiety.
B. perpetrating intentional harm on others.
C. an expression of conflict with others.
,D. a normal response to a perceived threat. correct answers a normal response to a perceived
threat.
The factor most likely to contribute to a client's escalating anger is
A. watching violence on television.
B. another client's depressed mood.
C. staff telling him he is "inappropriate."
D. staff asking how to be helpful. correct answers staff telling him he is "inappropriate."
Which item of assessment data is the best predictor of violence for a newly admitted client?
A. A recent assault on a drinking companion.
B. A family history of bipolar disorder.
C. The nurse's subjective feeling that client is cooperative.
D. A childhood history of being quick to anger. correct answers A recent assault on a
drinking companion.
When analyzing assessment data to arrive at nursing diagnoses for a nonpsychotic client who
displays much anger and occasional aggression, which nursing diagnosis would receive the
*least* initial consideration?
A. Social isolation
B. Risk for other-directed violence
C. Ineffective coping: overwhelmed
D. Ineffective coping: maladaptive correct answers Social isolation
Which neurotransmitter imbalance has been shown to have a relation to impulsive
aggression?
A. Low levels of γ-aminobutyric acid
B. Low levels of serotonin
C. High levels of dopamine
D. High levels of acetylcholine correct answers Low levels of serotonin
When working with an angry client it is best to
A. encourage the client to fully explore and express his anger.
B. help the client deny and repress the feelings of anger.
C. help the client reframe the anger-producing situation.
D. ignore the client's anger and change the subject. correct answers help the client reframe the
anger-producing situation.
Nurses coping with angry clients may find it helpful to remember that anger and aggression
begin as feelings of
A. isolation.
B. confidence.
C. competence.
D. vulnerability. correct answers vulnerability.
Which of the following would be the most appropriate response by the nurse to help a client
who is demonstrating escalating anger?
A. Walk the client to his room and help him practice stress-reduction techniques such as deep
breathing or muscle relaxation.
B. Suggest the client spend some time in the gym with a punching bag to relieve his stress.
, C. Suggest the client spend some time pacing rapidly in the hallway until he feels less
stressed.
D. Sit with the client in the day room so he can vent his anger and not isolate. correct answers
Walk the client to his room and help him practice stress-reduction techniques such as deep
breathing or muscle relaxation.
The more a nurse's intervention is prompted by emotion, the
A. less likely it is to be therapeutic.
B. less likely it is to be aggressive.
C. more likely it is to be effective.
D. more likely it is to be empathetic. correct answers less likely it is to be therapeutic.
The most restrictive method for dealing with an aggressive client who is out of control is
A. seclusion.
B. a show of force.
C. verbal intervention.
D. antipsychotic medication. correct answers seclusion.
Which client on the mental health unit is at *highest* risk for violence directed at others?
A. Mr. A, who has a history of recurrent severe depression
B. Mr. B, who is in an alcohol rehabilitation program
C. Mr. C, who has delusions of persecution and has assaulted his brother
D. Mr. D, who has somatic symptoms for which no organic basis is found correct answers
Mr. C, who has delusions of persecution and has assaulted his brother
A client is experiencing manic hyperactivity. In the dining room she stands up and shouts
"This food is garbage! I'll fight anyone who says it's not! I can fight all of you at one time and
win with one hand tied behind my back!" She is flushed, her fists are clenched, and she glares
challengingly at clients and staff. The nurse's most relevant assessment is that the client
A. is upset with the quality of the food.
B. is getting rid of tension in a harmless way.
C. is frustrated by limits imposed by hospitalization.
D. has a high potential for other-directed violence. correct answers has a high potential for
other-directed violence.
Which intervention strategy should be *avoided* by staff working with a client who is
shouting and flailing his arms?
A. Defusing the situation by laughing or making a joke of the challenge
B. Saying "Let's go to your room to talk about this"
C. Moving a few staff close together as a group to provide a show of force
D. Allowing one staff person to speak to the client while others provide support correct
answers Defusing the situation by laughing or making a joke of the challenge
An adolescent male is swearing and shouting at his physician, who refused to give him a pass
to leave the unit. This behavior
A. is acceptable if directed at staff but not when directed at other clients.
B. may reduce tension and prevent the client from physically acting out.
C. is a major indicator that the client may become physically aggressive.
D. can be attributed to lack of parental controls applied at an early age. correct answers is a
major indicator that the client may become physically aggressive.
Questions + A+ Verified Answers!!
Anger correct answers is the emotional response to frustration threats, or challenges and is a
normal response. We should not feel guilty about becoming angry but how we respond to that
anger may be a problem, venting anger may not be good in some cases.
Aggression correct answers is a harsh physical or verbal action that reflects rage hostility, and
potential for physical or verbal destructiveness.
Anger and hostility are also risk factors for: correct answers hypertension and cardiovascular
disease. Hostility has been shown to increase adrenocorticotropin and cardiovascular
responses to stress and to increase illness.
Behaviorists Theory- correct answers believe anger was a learned response to environmental
stimuli.
Social learning theorists correct answers such as Bandura, showed children learn by imitating
others and that people repeat behavior that is rewarded. Also children who grow up in angry
families learn to respond to frustration with anger and violence.
Cognitive based theory- correct answers although threat is usually understood as an alert to
physical danger, Beck noted that *perceived* assault on areas of personal domain, such as,
values, moral code, and protective rules can also lead to anger.
Causes of anger and aggression correct answers Brain abnormalities
Serotonin levels
Genetic and environmental factors
Brain abnormalities (Anger) correct answers - such as brain tumors, Alzheimer's temporal
lobe epilepsy, and traumatic injury to certain parts of the brain result in changes to
personality that includes increased violence.
One site known to be associated with aggression correct answers is the limbic system which
mediates primitive emotion and behaviors that are necessary for survival. The amygdala
mediates anger experiences. The temporal lobe is associated with high violence.
Serotonin levels- (Anger) correct answers studies have shown a relationship between
impulsive aggression and low levels of serotonin.
s/s risk of escalating anger leading to aggressive behavior. correct answers •Hyperactivity:
most important predictor of imminent violence (e.g., pacing, restlessness)
•Increasing anxiety and tension: clenched jaw or fist, rigid posture, fixed or tense facial
expression, mumbling to self (patient may have shortness of breath, sweating, and rapid
pulse)
•Verbal abuse: profanity, argumentativeness
•Loud voice, change of pitch; or very soft voice, forcing others to strain to hear
•Intense eye contact or avoidance of eye contact
,What is the single best predictor of future violence? correct answers history of violence
Milieu characteristics conducive to violence: correct answers Determine if environment is
conducive to anger management
Does the staff have the skills needed to handle angry aggressive clients
Are staff numbers adequate
Pre-assaultive stage: correct answers frequently verbal interventions are sufficient during this
stage.
Interventions in pre-assaultive stage: correct answers Analyze the client and situation
Use verbal techniques
Demonstrate respect for the client's personal space
Interact with the client
Invest time in the process
Pay attention to the environment
Assure your safety from violence by: correct answers Avoid wearing dangling jewelry
Have enough staff for backup
Always know the layout of the area
Do not stand directly in front of client or in front of doorway
If escalating provide feedback "you seem upset."
Avoid confrontation with the client either through verbal means or a show of force.
Assaultive stage: correct answers use of restraints, seclusion and medications. Throughout
this time, the team leader continues to relate to the client in a calm, steady voice,
communicating decisiveness, consistency, and control.
Postassaultive stage- correct answers once seclusion is no longer needed the staff should
review the incident with the client and with staff members. It can be a learning moment for
all concerned. For the client their out of control behavior.
Clients with cognitive deficits correct answers are particularly at risk for acting aggressively.
Can be from Alzheimer's or other dementia or brain injury.
Catastrophic reaction correct answers Sometimes the client with a cognitive disorders
experiences such severe agitation and aggression that it is referred to as a catastrophic
reaction.adopts a calm and unhurried manner.
Validation therapy for cognitive deficits correct answers lets you begin emotionally where the
client is
It grounds the client where he or she feels most secure
It is often more helpful to reflect back to the client the feelings behind her demand and to
show understanding and concern for her worry. As the nurse establishes himself or herself as
a safe understanding person, the client becomes calmer and more open to redirection.
Anger can be defined as
A. an unhealthy way of releasing anxiety.
B. perpetrating intentional harm on others.
C. an expression of conflict with others.
,D. a normal response to a perceived threat. correct answers a normal response to a perceived
threat.
The factor most likely to contribute to a client's escalating anger is
A. watching violence on television.
B. another client's depressed mood.
C. staff telling him he is "inappropriate."
D. staff asking how to be helpful. correct answers staff telling him he is "inappropriate."
Which item of assessment data is the best predictor of violence for a newly admitted client?
A. A recent assault on a drinking companion.
B. A family history of bipolar disorder.
C. The nurse's subjective feeling that client is cooperative.
D. A childhood history of being quick to anger. correct answers A recent assault on a
drinking companion.
When analyzing assessment data to arrive at nursing diagnoses for a nonpsychotic client who
displays much anger and occasional aggression, which nursing diagnosis would receive the
*least* initial consideration?
A. Social isolation
B. Risk for other-directed violence
C. Ineffective coping: overwhelmed
D. Ineffective coping: maladaptive correct answers Social isolation
Which neurotransmitter imbalance has been shown to have a relation to impulsive
aggression?
A. Low levels of γ-aminobutyric acid
B. Low levels of serotonin
C. High levels of dopamine
D. High levels of acetylcholine correct answers Low levels of serotonin
When working with an angry client it is best to
A. encourage the client to fully explore and express his anger.
B. help the client deny and repress the feelings of anger.
C. help the client reframe the anger-producing situation.
D. ignore the client's anger and change the subject. correct answers help the client reframe the
anger-producing situation.
Nurses coping with angry clients may find it helpful to remember that anger and aggression
begin as feelings of
A. isolation.
B. confidence.
C. competence.
D. vulnerability. correct answers vulnerability.
Which of the following would be the most appropriate response by the nurse to help a client
who is demonstrating escalating anger?
A. Walk the client to his room and help him practice stress-reduction techniques such as deep
breathing or muscle relaxation.
B. Suggest the client spend some time in the gym with a punching bag to relieve his stress.
, C. Suggest the client spend some time pacing rapidly in the hallway until he feels less
stressed.
D. Sit with the client in the day room so he can vent his anger and not isolate. correct answers
Walk the client to his room and help him practice stress-reduction techniques such as deep
breathing or muscle relaxation.
The more a nurse's intervention is prompted by emotion, the
A. less likely it is to be therapeutic.
B. less likely it is to be aggressive.
C. more likely it is to be effective.
D. more likely it is to be empathetic. correct answers less likely it is to be therapeutic.
The most restrictive method for dealing with an aggressive client who is out of control is
A. seclusion.
B. a show of force.
C. verbal intervention.
D. antipsychotic medication. correct answers seclusion.
Which client on the mental health unit is at *highest* risk for violence directed at others?
A. Mr. A, who has a history of recurrent severe depression
B. Mr. B, who is in an alcohol rehabilitation program
C. Mr. C, who has delusions of persecution and has assaulted his brother
D. Mr. D, who has somatic symptoms for which no organic basis is found correct answers
Mr. C, who has delusions of persecution and has assaulted his brother
A client is experiencing manic hyperactivity. In the dining room she stands up and shouts
"This food is garbage! I'll fight anyone who says it's not! I can fight all of you at one time and
win with one hand tied behind my back!" She is flushed, her fists are clenched, and she glares
challengingly at clients and staff. The nurse's most relevant assessment is that the client
A. is upset with the quality of the food.
B. is getting rid of tension in a harmless way.
C. is frustrated by limits imposed by hospitalization.
D. has a high potential for other-directed violence. correct answers has a high potential for
other-directed violence.
Which intervention strategy should be *avoided* by staff working with a client who is
shouting and flailing his arms?
A. Defusing the situation by laughing or making a joke of the challenge
B. Saying "Let's go to your room to talk about this"
C. Moving a few staff close together as a group to provide a show of force
D. Allowing one staff person to speak to the client while others provide support correct
answers Defusing the situation by laughing or making a joke of the challenge
An adolescent male is swearing and shouting at his physician, who refused to give him a pass
to leave the unit. This behavior
A. is acceptable if directed at staff but not when directed at other clients.
B. may reduce tension and prevent the client from physically acting out.
C. is a major indicator that the client may become physically aggressive.
D. can be attributed to lack of parental controls applied at an early age. correct answers is a
major indicator that the client may become physically aggressive.
